African chief evangelizes about adult circumcision

African Chief Jonathan Eshiloni Mumena will eagerly tell you about his ivory Star of David ring and the Texas flag on his tie.

But Mumena’s real passion has recently turned to advocacy for adult circumcision to prevent the spread of HIV/AIDS.

In some African countries, tribes have shunned circumcision because it was seen as a Muslim practice or was simply considered primitive.

“We thought they were born differently and had to reconfigure the way they were,” said Mumena.

So the tribal chief was not prepared for his son’s declaration that he wanted to get circumcised. Mumena read the pamphlets on circumcision’s health benefits, which argue that the procedure cuts HIV transmission by 60 percent, and agreed with his 18-year-old son.

Risking impeachment by the 60,000 members of his tribe, he had the procedure done in 2011 at the age of 47.

Mumena is among a growing number of Zambians opting for circumcision as a way to ward off HIV infection. In so doing, they are adding to the number of people who take on this ancient practice for cultural or religious reasons.

Mumena is also a Christian, and he is finding biblical justifications for circumcision.

“If it was good enough for God’s people in Leviticus, it is good enough for me,” he said. “I have made a stand for circumcision because of what the Bible has taught me. God demands good hygiene from his people as a way of living.”

Mumena attends an evangelical church and is also a lay preacher. His advocacy on behalf of circumcision has brought him attention from people like Microsoft founder and philanthropist Bill Gates, who has called Mumena one of Africa’s “true heroes.”

Circumcision has become a popular tool to fight HIV/AIDS and cervical cancer. In 2012, the Zambian Ministry of Health launched a national campaign to circumcise 2 million men by 2015. The U.S. President’s Emergency Plan for AIDS Relief has committed $11.4 million to support Zambia’s efforts.

“Male circumcision is the best vaccine in Africa,” says Dr. Manasseh Phiri, a Zambian HIV/AIDS activist who was inspired by Mumena to get circumcised.

In Zambia, 13 percent of adults have been infected with HIV, compared with nations like Swaziland (26%), Botswana (23%) and South Africa (17%), according to the United Nations.

Circumcision is not just a male issue, Phiri said. Women are beginning to demand it as a way to stem cervical cancer from spreading.

“If we can change individual behavior at the bedroom level, we can have this cracked,” he said.

There’s a danger in overemphasizing circumcision, said Dr. Philip Thuma, a longtime researcher in Zambia.

“We in the West right now are fixated on male circumcision in the same way we were fixated on bed nets for malaria,” Thuma said. “It’s only one of many things.”

Health experts also explain that circumcision is not a magic bullet. Some men assume that if they are circumcised, they have almost no risk of contracting HIV.

“Male circumcision is just part and parcel of all the strategies,” said Albert Mwango of Zambia’s Ministry of Health. “It is only useful if the other risk reductions are taken into account.” Other strategies include use of condoms, a controversial method for many faith-based health organizations.

It’s difficult to measure how many have followed in his footsteps, Mumena said, but he sees changes being made.

“I can safely conclude that we have had people circumcised from every tribe because now it has become the ‘in’ thing,” Mumena said.

Described as the best-dressed chief in Zambia by Thuma, Mumena offers some flair with his wardrobe. The Texas flag on the chief’s tie? He became an honorary resident of Abilene, Texas. And the Star of David jewelry? Like many evangelicals, he just loves Israel.

Mumena may cite his faith to promote circumcision, but he’s also eager to suggest it as a practice for everyone, irrespective of religion.

“It doesn’t matter whether we’re Christians, if we believe in the faith, or not,” he said. “HIV/AIDS respects no religion. It’s about survival.”

Sarah Pulliam Bailey reported on HIV/AIDS, tuberculosis and malaria in Zambia with the International Reporting Project.

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From a USAID report:
"There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
It seems highly unrealistic to expect that there will be no risk compensation. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms".
It is unclear if circumcised men are more likely to infect women. The only ever randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised:
ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them.

by Mark Lyndon

August 16, 2013

Re: Article of the 12 August discussing circumcision: I have never heard that female circumcision (mentioned in article as a way to prevent HIV transmission) has ever been indicated as effective. On the contrary, this practice has been used for many years in some parts of the world--sometimes, to reduce female sexual pleasure and perhaps prevent married infidelity by females. It causes mutilation, risk of infection, and even death to women. The practice has been condemned by world agencies. I realize that PCUSA has merely reported this article--but having done so, it needs to report any errors that were made in the article. Please check into the whether the statement concerning female circumcision benefits in preventing disease is true--and make any needed corrections. Thanks for your attention.

by lynnecastle

August 12, 2013

I fail to see how circumcision of females would prevent cervical cancer in any way at all. Cervical cancer is spread by virus and circumcision, to the best of my knowledge, will not prevent it. This needs to be checked out medically by PCUSA leaders and exposed as incorrect, if it is. I might add that female circumcision has been used for some time in Africa to reduce female pleasure to prevent supposed marital infidelity--this practice has been condemned by a number of agencies--and I would expect PCUSA would condemn it for this reason as well. I know this is a news article, but, having shared it online, PCUSA is responsible for correct information on the issue presented.
Thanks for your consideration.

by lynnecastle

August 12, 2013

From a USAID report:
"There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher."
http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf
It seems highly unrealistic to expect that there will be no risk compensation. The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups "believe that circumcised men do not need to use condoms".
http://www.info.gov.za/issues/hiv/survey_2009.htm
It is unclear if circumcised men are more likely to infect women. The only ever randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract
ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery seems likely to cost African lives rather than save them.

by Mark Lyndon

August 12, 2013

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